ANATOMICAL CHARACTERS. 165 



It is to be observed tliat tlie suppurative process iii tlie 

 more severe forms of phlegmonous erysipelas is accompanied 

 by Avell-marked serous effusion, and that the pus of a thin and 

 sanious character is more frequently infiltrated amongst the 

 areolae of the tissues than circumscribed and bounded by 

 adhesive inflammation so as to form a well-defined abscess. 



Necroscopic examination discloses alterations chiefly in con- 

 nection with the local manifestations of the disease, some 

 peculiar changes in the composition of the blood, and certain ad- 

 ventitious appearances in the organs of respiration and digestion. 

 The character of the exudate permeating the meshes of the 

 connective-tissue and vascular layer of the cutis varies from a 

 structureless hyaline material to one of considerable density 

 and distinctly fibrilated. When the inflammatory process and 

 attendant disintegrative action extend to other and deeper- 

 seated organs and structures, the changes observed by the 

 naked eye are those consequent on the peculiar morbid action ; 

 specially we encounter infiltration of tissues with the products 

 of this action, and general and minute structural changes, dis- 

 integration, death, and removal, not merely of the normal 

 structures, but also of the new products themselves. 



The question of the presence, both in the local lesions and 

 in the blood itself, of certain low forms of organization, pro- 

 bably constituting the animate contagia of the disease, re- 

 quires further proof ere it is received without certain modi- 

 fications. 



Symptoms. — These are of two kinds, the constitutional or 

 general, and the local ; they are of very differing degrees of 

 intensity. 



The constitutional fever, which as a rule precedes, or at 

 least is coincident with, the appearance of the local symptoms, 

 is in young subjects, and those of a full habit of body, 

 generally of the acute or sthenic type ; in older animals, or 

 those previously debilitated or suffering from the depressing 

 influences of adverse local sanitary or dietetic conditions, the 

 low or asthenic form is likely to prevail. Whatever may be 

 the form of the fever at the outset of the disease, it will in all 

 but the very mildest cases become truly hectic, most probably 

 passing on to a low, prostrating form, and when having a fatal 

 issue terminating by collapse. 



